The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

February 01, 2012 #4,373 Publisher-Barry Block, DPM, JD

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VA Podiatrist Says Veteran's Condition is Related to Agent Orange Exposure

Kenny Garner has cancer, diabetes, and other problems that he believes are caused by exposure to Agent Orange during the Vietnam War. He gets a disability check each month from the Department of Veterans Affairs for a portion of the ailments. He has requested more money because of his deteriorating condition, but has been told he doesn't qualify. His toes are curled up from damage to nerves, and he no longer can control some bodily functions. 

Dr. John Cook

But Garner's podiatrist, Dr. John Cook of Fredericksburg, told VA officials there is a connection between military service and his illnesses.
"Agent Orange produced diabetes, the diabetes has destroyed his nerve fibers," Cook wrote in an August 2010 letter. "Agent Orange is the causal agent for his peripheral neuropathy."
 
Source: Cathy Dyson, Fredericksburg Free Lance-Star [1/30/12]

Barry Honors PICA for $60,000 Contribution

Barry University’s School of Podiatric Medicine honored the Podiatric Insurance Company of America (PICA) Group for its $60,000 commitment to provide future PICA Scholarships to deserving Barry podiatric medical students. Dr. Jeffrey Jensen, dean and professor of podiatric medicine and surgery presented an award to Dr. Jerry Brant, PICA Group President and Chief Executive Officer and Dr. Ross Taubman, Executive Vice President and Chief Medical Officer.

(L-R) Drs. Jerry Brandt, Jeffrey Jensen, and Ross Taubman

The commitment from PICA to the podiatric medical education at Barry will provide $35,000 in support for costs of the Rite of Passage Ceremony over the next five years including white lab coats, invitations, and keepsake programs, among other things. The PICA Scholarships of $25,000 will provide two $2,500 scholarships each year to Barry podiatric students over the next five years.

GA Podiatrist Not Surprised by Decrease in Diabetes-Related Amputations

The CDC says diabetics are doing a better job of managing the risk factors that lead to the loss of feet and legs. That’s one of the reasons behind the big drop in amputations. Foot and leg amputations occurred in 4 out of every 1,000 adults with diabetes in 2008, compared to 11 out of every 1,000 in 1996, the CDC reports.

Dr. Alap Shah

Dr. Alap Shah, a podiatrist at Foot and Ankle of West Georgia says there are other reasons for the decline. He says patients are more aware now, they have more information at their fingertips. He also credits new treatment options for the decline. “I was actually not really surprised because of the wave of new medications that have come out now to treat diabetes, and also the new wound care products that have been out on the market," says Dr. Shah.

Source: Teresa Whitaker, WRBL News [1/29/12]

NJ Podiatrist Photographs Rare Bonzai Trees for New Book

A retired Bayonne foot doctor whose large format photographs of rare and exotic plants have stunned both the art and science world has overcome ill health to publish a new book of Japan’s most prized Bonsai trees and shrubs. Although sick with a heart condition, Parkinson’s disease, and deep vein thrombosis, Dr. Jonathan Singer, 64, spent last summer in 100-degree temperatures photographing trees in seven of the most exclusive Bonsai Gardens in Japan.

Rare Bonzai Tress Photographed by Dr. Jonathan Singer

The more than 20 photographs of ancient miniature maples, junipers, and pines found in Bonsai Gardens in Japan and the United States are to be published in a new book, Bonsai: Art & Nature in April by Abbeville Press. Milton Estorow, former New York Times reporter and publisher of ArtNews, describes Singer as one of the “world’s most gifted photographers.”

Source: Charles Hack, The Jersey Journal [1/30/12]

Editor's Note: PM News is proud to present excerpts from Meet the Masters.

Bret Ribotsky: How can DPMs get involved in the Special Olympics, and how can it benefit their practices? 

Dr. Patrick Nunan

Patrick Nunan: First, contact me at pjndpmrun@aol.com. I think getting involved in the local community is a great first step. We want to find good people so that we can train them. People who are passionate about this are best. Those who treat these athletes will make a difference in their lives. Participating podiatrists will reap the rewards, both internally and from the countless patients, parents, and grandparents who will seek out podiatric services.

Dr. Harry Goldsmith

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). This week's guest is coding  expert Dr. Harry Goldsmith, CEO of Codingline.com.  You can register for future events by clicking here

Query: Pre-operative E/M Service

Just to clarify, can an E/M service be billed if a patient comes into the office to sign a consent for surgery when that visit occurs about a week before surgery?

Isidore Steiner, DPM, Howell, MI

Response: Yes, in my opinion, you can. Major surgeries have a global of 90 days, which means one day before and ninety days after the surgery. If you see a patient 7 days before a major surgery and perform an appropriate and necessary history, physical with decision-making,  technically qualifying the evaluation and management service - I believe you can bill for the E/M service when supported by your chart documentation.

Mark Schilansky, DPM, Catskill, NY

Codingline subscription information can be found here
APMA Members: Click here for your free Codingline Silver subscription

RE: Plantar Fascial Tears After Cipro? (David Weiss, DPM)
From: Jeff Mennuti, DPM

The mechanism of tendon injury from fluoroquinolone is still uncertain. Studies show that ciprofloxacin causes up to a 68% reduction in cell proliferation, and up to a 48% reduction in collagen synthesis on damaged tendons. The same study also shows increase of  matrix-degrading proteolytic activity after 72 hrs. There is also an increased risk if the patient is taking long-term steriods, anti-gout meds, or has rheumatoid arthritis.

Although there is no data about plantar fascia, it is not out of the realm of reason. There is no test to prove that this was caused by the Cipro. There is no reason to throw anyone under the bus. Also, that PCP didn't force the patient to take the medication.

Jeff Mennuti, DPM, Orange City, FL, dr.mennuti@gmail.com

RE: The Use of Uloric vs. Allopurinol in the Management of Gout (David J Kaplan, DPM)
From: Jon Purdy, DPM

This forum is a great place for colleagues to assist each other in providing excellent patient care and practice management advice for diseases like gout. Because scope of practice differs from state to state, community standards and resources vary widely, and individual podiatrist comfort levels differ as well, it seems the degree of treatment should be left to the discretion of the individual podiatrist.

Since there is insufficient high-quality evidence that exists for recommending one therapy over another in the case of gout, some may be surprised to know that there are currently no guidelines for treatment. However, the American College of Rheumatology (ACR) has, as of December 2011, posted a preliminary set of guidelines...

Editor's note: Dr. Purdy's extended-length letter can be read here.

RE: Sammy EMR System (Jack Ressler, DPM)
From: Wes Daniel, DPM

I chose the Sammy Systems program over others about a year ago. At the time, I was using Practice Fusion which was not certified, did not have all the bells and whistles, and was actually time-consuming (but has markedly improved since then). I have been extremely pleased with my choice. The program practically runs itself. It lets you know when the 61st day is for recurring care. It reminds you about smoking cessation counseling, it reminds you about allergies or other important notes, and it reminds you about PQRS .

My staff thanks me almost daily for using this system. The billing system is automatically integrated. The training was easy and comprehensive. The service has been great. When we turn on the computers in the AM, there are updates ready to be downloaded. If trouble arises, their response is virtually immediate. We have never had to wait more than 2-3 hours to have a problem addressed. They are always courteous and are willing to bend over backwards to accommodate your needs. They walked me through the attestation, and I was able to collect the $18K check last year. I would not hesitate for a second to recommend the Sammy System to anyone looking for an EMR program.

Wes Daniel, DPM, Gainesville, GA, wdan-gpma@mindspring.com

RE: New MD Shoe Company Tells People to “Ditch Your Orthotic” (Kevin Kirby, DPM)
From: Brian Kiel, DPM

I recently posted a response to the claims of the makers of the OESH shoes. I disputed their claims as to ability to cure foot pathology and their claims to have scientific evidence to back up their claims. If you go to the site, my post has been eliminated, and I have been blocked from the site. If anyone wants to challenge their claims, as I think we should, go to the OESH site on Facebook and post a response.
 
Brian Kiel, DPM, Memphis, TN, footdok4@gmail.com

RE: Amputations Due To Diabetes Fell More Than Half Since Mid 1990s
From: Pete Harvey, DPM

Thanks for Dr. Levy’s contribution of the ariticle stating that diabetic amputations have been decreased by one half since 1990.

I hope that the government is well aware of this and understands the importance of continuing the diabetic shoe program. This has, without question, been a team effort comprising endocrinologists, family physicians, podiatrists, more effective wound care, diabetic education programs, and increased patient knowledge levels.
 
Pete Harvey, DPM, Wichita Falls, TX, pmh@wffeet.com

SPACE AVAILABLE - NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview, Long Island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

POSITION WANTED

ACFAS Fellow Board Certified in both Foot and Reconstructive Hindfoot/Ankle Surgery with 10 years of experience in all aspects of podiatric medicine and surgery seeking a good fit for part-time venture leading to long-term association or partnership. Excellent communicator with outstanding interpersonal skills and exceptional bedside manner. Skilled in seeing high patient volume. Contact  njfootdoc123@gmail.com

ASSOCIATE POSITION - CENTRAL NJ

Looking for a three-year surgically-trained associate who has entrepreneurial spirit. Partnership guaranteed within three years for the right person. Must be very outgoing and personable. Great opportunity for a person who is confident and a go getter. drwfoot@verizon.net

 ASSOCIATE POSITION – FLORIDA

Emerald Coast on the North Shore of the Gulf of Mexico, a well-established group practice with multi-offices, seeking an associate with opportunity for partnership for a PSR-24/36 Doctor well-trained in foot/ankle/diabetic problems/wound care/surgical and medical podiatric care, covering 3 area hospitals, NO nursing homes. e-mail letter of interest, CV, and references to basewedge@yahoo.com

ASSOCIATE POSITION - PHILADELPHIA, SOUTHERN NEW JERSEY

Seeking motivated, independent foot & ankle surgeon to join large practice. Our multi office practice covers all aspects of foot and ankle pathology, including heavy limb salvage/ hospital volume. Offering competitive salary and benefit package. Send CV and two references to: bleich5252@yahoo.com

ASSOCIATE POSITION - NEW YORK

WORK SMARTER NOT HARDER. Join a modern, well-established 42-year-old podiatric medical/surgical practice within a multi-specialty office. Located just 20 minutes from NYC. Must be responsible, compassionate, driven, and self-starter. Enjoy cross-referrals from other specialists and support of medical assistants, office managers, and medical billers with over 50 years combined experience. Utilize modern technology: state-of-the-art diagnostic ultrasonography, fluoroscopy, ESWT (machine is owned by practice), physical therapy, x-ray, circulation testing, NCV, and in-office operatory suite. Very strong and effective advertising/marketing program. No nursing homes, No HMOs, No Medicaid, No Medicare. Must be licensed for podiatry in New York. Send cover letter/CV to: linchpindpm@yahoo.com.

ASSOCIATE POSITION - TEXAS - SUBURBAN NORTH DALLAS 

Great opportunity for the right individual. Seeking well-trained (PSR 24+), ethical, hard-working, motivated individual. Full scope of podiatry including office, hospital and surgery center work.  Partnership opportunity available. Well-rounded practice with competitive salary/benefits package. Please send letter of intent, CV and current photo to dpmposition@yahoo.com

ASSOCIATE POSITION - NORTHWEST CHICAGO SUBURBAN AREA

Medical-surgical podiatry practice seeking well-trained individual to work full-time with future partnership opportunity. PSR-36 a minimum. Send CV to feetdpm@yahoo.com

PART-TIME PODIATRIST NEEDED - LOS ANGELES, CALIFORNIA

Busy podiatrist looking for assistance with patients located in facilities, homes, office, etc. Flexible hours, independence, and great compensation. If interested email CV to homefootcare@hotmail.com or call Terri at 323-353-8103.

ASSOCIATE POSITION - KANSAS CITY, MISSOURI

I'm not just looking for an associate. I am looking for a doctor who wants to build a highly successful career with a doctor who is as committed to their success as he is to his own. Go to www.YourFutureInPodiatry.com to find out about this opportunity.

ASSOCIATE POSITION - LONG ISLAND, NY

Full time associate position available with well rounded multi-office group on Long Island. Ideal position for July 2012 graduating third year resident who wants to practice and live on Long Island. Candidates must be board qualified or board certified, and well trained in all phases of podiatry including surgery, biomechanics, wound care and palliative care. Compensation includes salary,malpractice insurance, paid vacations and surgical incentives, with a future partnership opportunity available for the right candidate. Interested doctors are encouraged to submit their CV's in response to: mets724@gmail.com

PRACTICE FOR SALE - SOUTHERN CALIFORNIA (ORANGE COUNTY)

Strong & diverse local economy, in a beautiful beach community. Well rounded, established since 1983, fully equipped. Consistently grossing over $600K. Many types of insurance, reimbursement and revenue sources. Local hospitals allow full scope of podiatric care. Terms available. Contact:josephdpm@gmail.com

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